How much rates vary
Facilitymedian $2,512 · 10th to 90th $389 to $6,457Professionalmedian $162 · 10th to 90th $68 to $398
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $104.71 Median $371.54 Typical High $4,897.79 | Facility | None | $104.71 | $371.54 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $213.80 Typical High $371.54 | Professional | None | $74.13 | $213.80 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,089.30 Median $2,818.38 Typical High $6,309.57 | Facility | None | $2,089.30 | $2,818.38 | $6,309.57 |
BCBS Michigan Setting Professional Modifier None Typical Low $18.20 Median $114.82 Typical High $537.03 | Professional | None | $18.20 | $114.82 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $229.09 Typical High $537.03 | Professional | None | $81.28 | $229.09 | $537.03 |
Health Alliance Plan Setting Facility Modifier None Typical Low $112.20 Median $691.83 Typical High $7,413.10 | Facility | None | $112.20 | $691.83 | $7,413.10 |
Health Alliance Plan Setting Professional Modifier None Typical Low $100.00 Median $275.42 Typical High $398.11 | Professional | None | $100.00 | $275.42 | $398.11 |
Priority Health Setting Professional Modifier None Typical Low $81.28 Median $223.87 Typical High $416.87 | Professional | None | $81.28 | $223.87 | $416.87 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,288.25 Typical High $2,089.30 | Facility | None | $302.00 | $1,288.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $95.50 Median $257.04 Typical High $363.08 | Professional | None | $95.50 | $257.04 | $363.08 |
11 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $104.71 Typical High $186.21 | Professional | 52 · Reduced service | $52.48 | $104.71 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $42.66 Typical High $74.13 | Professional | 53 · Discontinued | $20.89 | $42.66 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $158.49 Typical High $281.84 | Professional | 54 · Surgery only | $77.62 | $158.49 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $31.62 Typical High $56.23 | Professional | 55 · Aftercare only | $15.49 | $31.62 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $21.38 Typical High $37.15 | Professional | 56 · Pre-op care only | $10.47 | $21.38 | $37.15 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $234.42 Typical High $812.83 | Professional | 50 · Both sides | $173.78 | $234.42 | $812.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $87.10 Typical High $199.53 | Professional | 52 · Reduced service | $52.48 | $87.10 | $199.53 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $35.48 Typical High $79.43 | Professional | 53 · Discontinued | $20.89 | $35.48 | $79.43 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $131.83 Typical High $302.00 | Professional | 54 · Surgery only | $79.43 | $131.83 | $302.00 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $26.30 Typical High $60.26 | Professional | 55 · Aftercare only | $15.85 | $26.30 | $60.26 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $17.38 Typical High $39.81 | Professional | 56 · Pre-op care only | $10.47 | $17.38 | $39.81 |
Where Michigan sits
The same service costs 4.2 times more in Washington than in Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Michigan· 44th of 51
$162
WA $447VA $107
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.